Page 8 - Hickory Crawdads 2022 Flipbook

PRESCRIPTION DRUG COVERAGE

Program
A prescription drug program is offered as part of your health care

benefits. This program covers both non-maintenance and maintenance
prescription drugs dispensed by either pharmacy or designated mail
service
Medicare Part D
Retail Program The company’s prescription drug
The retail program provides up to a 31-day supply of medication. Simply plan is creditable coverage. That
present your ID card at a participating pharmacy nationwide and pay means it meets and exceeds
the appropriate co-pay or coinsurance amount for your medication. Medicare Part D requirements and
the benefits offered by most
Medicare Part D plans. If you are
Mail Order Program eligible for Medicare, you may
receive
continue
to
your
The mail service program is a convenient way for you order prescription drugs under this plan.
medications. Your prescription is reviewed and dispensed by You do not need to enroll in a
registered pharmacists and mailed directly to your home. separate Medicare D drug plan.

Maintenance Drugs
Up to a 90-day supply of maintenance drugs is available through
the mail order pharmacy. Maintenance medication is a prescription drug
anticipated to be required for 6 months or more to treat a chronic
condition.

PPO Prescription Plan PPO Prescription Plan

$150 Individual Deductible
Prescription Drug Deductible $450 Family Deductible
(separate from medical)

$20 Generic
Retail: 31-Day Supply $30 Brand
$60 Non-Formulary Brand

$40 Generic
Maintenance Drugs through Mail Order: 90- day $60 Brand
supply
$120 Non-Formulary Brand

2022 Hickory Crawdads Benefit Guide Page 8